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Billing Process Update

We recently made changes to our billing process that may affect your co-payments, co-insurance and annual deductible. The new process, called hospital-based billing, is being adopted by many large health systems nationally because it allows for a more integrated, accurate process for insurance billing. This change will not affect patients with Medicare or Medicaid coverage.

How this new process will affect you will depend on your insurance. For details on how hospital-based billing will impact your costs, please contact your insurance company.

We realize that this change may cause you to have questions or concerns. Additional information is outlined below, under Frequently Asked Questions. If you have additional questions, or want to learn more, please call (800) 424-4840 and a financial representative will be happy to speak with you.

Frequently asked questions

What does 'hospital-based billing' mean?

Hospital-based billing is the two-part billing process for services provided at a hospital or at one of its outpatient centers. A patient receives two bills: one for the physician’s fees (often called “professional fees”) and one for other costs, such as medical supplies and nursing care (“technical fees”).

Why is Loyola switching to hospital-based billing?

This is the same billing process that is already in place for Medicare patients and for inpatient hospital stays. Large health systems nationwide are making the switch to hospital-based billing (sometimes called “provider-based billing”) for physician office visits in order to bring greater accuracy and consistency to the billing process. Medicare and Medicaid patients will not be affected by this change.

What charges are included in the two bills I will receive?

After Sept. 30, 2013, you will receive one bill for your physician’s fees (a bill called “Statement of Physician Services”) and another that covers other costs (a bill from “Loyola University Medical Center”). If you have ever been a hospital inpatient, you are familiar with this type of billing. This change will ensure that all of your bills, both inpatient and outpatient, are handled in a consistent manner.

Will I still pay just my co-pay?

You will still be responsible for your co-pay. It’s best to speak to your insurance company to determine how your particular plan will process claims and whether you will incur any additional costs as a result of the divided bill. In some cases, these bills may be processed as an outpatient hospital claim. Depending on your insurance policy, these bills may lead to separate co-pays, deductibles and/or co-insurance and could result in slightly higher out-of-pocket costs for you.

 

Will I have to pay anything for annual wellness exams or immunizations?

We have found that most insurance companies will continue to process claims as they did before the switch to hospital-based billing. Each company has its own rules, however, so it’s best to check with your insurance carrier.

I have a question about a specific bill. Whom should I call?

You may speak to a representative at Patient Financial Services during business hours on weekdays at (800) 424-4840.